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Evaluation of the elderly hypertensive.

H R Black1

  • 1Section of Cardiology, Yale University School of Medicine, New Haven, CT.

Geriatrics
|October 1, 1989
PubMed
Summary

Evaluating elderly hypertensive patients requires special attention to comorbidities and risk factors. Key tests include blood count, urinalysis, metabolic panel, lipid profile, and electrocardiogram for comprehensive assessment.

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Area of Science:

  • Geriatric Medicine
  • Cardiology
  • Internal Medicine

Background:

  • Hypertension management in the elderly presents unique challenges compared to younger populations.
  • Older adults frequently have multiple risk factors and coexisting medical conditions (comorbidities) that influence hypertension.
  • While secondary hypertension is uncommon, atherosclerotic renovascular hypertension is a notable concern in this demographic.

Purpose of the Study:

  • To outline the essential components for evaluating elderly patients with hypertension.
  • To highlight the importance of identifying associated risk factors and comorbidities in geriatric hypertension.
  • To specify recommended diagnostic tests for initial assessment.

Main Methods:

  • Review of clinical guidelines and literature pertaining to geriatric hypertension evaluation.
  • Emphasis on a thorough patient history to uncover risk factors and comorbidities.
  • Recommendation of specific laboratory and diagnostic tests for initial workup.

Main Results:

  • Standard hypertension evaluation requires modification for elderly patients.
  • Common comorbidities and risk factors necessitate careful consideration.
  • Atherosclerotic renovascular hypertension is an important differential diagnosis in specific subgroups (e.g., white, smokers, resistant hypertension).

Conclusions:

  • Comprehensive evaluation of elderly hypertensive patients demands attention to age-related factors.
  • Initial recommended tests include complete blood count, urinalysis, serum electrolytes, glucose, creatinine, lipid profile, and electrocardiogram.
  • Further specialized investigations may be warranted based on individual patient findings.

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